NORI gets status of postgraduate training institute

Islamabad

At a time when the subject of health is building a negative international image of Pakistan, largely because of the country’s poor performance in polio eradication, the wonderful news of the Nuclear Medicine, Oncology and Radiotherapy Institute (NORI) being awarded the status of postgraduate education and training centre by the Pakistan Medical and Dental Council (PMDC) sounded like music to the ears of participants attending the concluding session of the month-long awareness campaign for breast cancer here on Saturday.

The elevation of the status of NORI will help meet the deficiency of oncologists in Pakistan, a country which is harbouring a growing number of cancer patients. It is time now for the government to expedite the establishment of a national cancer registry so that the actual burden of cancer can be measured and preventative measures taken.

As many as 454 women and 2 men availed free screening at NORI during October, which was observed as breast cancer awareness month, with numerous activities being organised by the Oncology Department of NORI in collaboration with NORI Patients’ Welfare Society (NPWS) and Pakistan Society of Clinical Oncology (PSCO). Of these 456 patients, 43 (10%) were harbouring breast cancer and were totally ignorant about it. “The fact that these patients were diagnosed in stage-1 of the disease is our success,” said the head of the Oncology Department, Dr. Mohammad Faheem. He added that 3% of the screened patients were advised biopsy and 2% were advised regular follow-up.

A few women among those who turned up for screening had already been diagnosed but had not sought timely treatment due to poverty, taboos or other reasons. “These women also mustered courage and reported at NORI for free consultation and examination, and were convinced to get treated. All screened women were provided reports the same day,” Dr. Faheem took pride in mentioning. He advised patients to have a positive outlook when opting for screening because cancer is treatable.

Dr. Faheem shared that at the start of the month, the number of women coming for screening was in the range of 15 to 20 per day. After Eid, breast cancer screening gained momentum and the number of screened women rose to more than 30 per day. After the grand seminar on breast cancer awareness on October 25, the number further swelled to more than 60 per day. These numbers clearly demonstrate how successful the campaign proved to be.

Dr. Faheem lamented that although Pakistan is a nuclear power, health is yet to be taken up as a priority. He stated that the number of new cancer patients at NORI has risen from 1,777 in 1998 to 4,247 in 2014. The number of breast cancer patients is also persistently on the rise; their number has increased from 333 in 2000 to 710 in 2014. Pakistan, he said, has the highest rate of breast cancer in Asia.

Dr. Faheem recapitulated the activities that NORI organised as part of its month-long breast cancer awareness campaign, which kicked off on October 2 with a mini-symposia and included extensive dissemination of brochures and information leaflets on breast cancer screening, smoking and cancer, radiation treatment, side-effects and remedies for chemotherapy administration, nutritional guidelines for cancer patients, etc. Free consultation and breast cancer screening services were provided throughout the month. A grand seminar was then held on October 25 to express solidarity with patients.

Major General (r) Syed Guftar Shah, member administration at the PAEC, was the chief guest on the occasion. He informed that PAEC is catering to 75% of all cancer patients in Pakistan, irrespective of their financial status and the stage of their disease. He shared that another three cancer centres (in addition to the 18 already established by PAEC) will soon be set up in areas including Mardan and Gilgit. He wished other hospitals in Pakistan also had the same sympathetic approach towards patients as witnessed at NORI. He was confident that the grant of postgraduate training status to NORI would give impetus to its progress, leading to an increase in the number of oncologists. He urged doctors to be true to their profession, and to always greet patients with a smile. He congratulated the hospital administration and members of NPWS for the exceptionally enviable reputation that their Society enjoys.

Guftar pointed out that the percentage of patients suffering from cancer but currently unaware of their health condition is very high. “It will be a huge service if we are able to generate awareness,” he remarked, while appreciating NORI for its month-long awareness initiative.

NORI Director Dr. Javaid Irfan introduced the guest speakers and shared details of the treatment and diagnostic services being provided by NORI, a 110-bed facility with isolation rooms and a new daycares unit for chemotherapy patients. He shared that NORI will soon be establishing Pakistan’s first nano-medicine department, for which all facilities have been acquired.

Consultant Oncologist Dr. Humera Mahmood highlighted the significance of breast cancer screening in early detection and timely treatment. Cancer screening, she said, is synonymous to secondary prevention, which refers to detection of the disease at a stage that would not otherwise have been possible without screening. Breast cancer screening started in the 1960s with mammography, and has resulted in reduction in breast cancer related mortality by as much as 25% to 58%. She reiterated that the benefits of screening are more evident in women aged between 40 and 70 years because the tumour grows rapidly in this age group. There is substantial evidence in favour of screening for breast cancer, she remarked.

Dr. Humera Mahmood regretted that breast cancer patients in Pakistan present at an advanced stage of the disease when prognosis is poor and breast conservation is not possible. “Early detection saves lives; one of them could be yours. So get yourself screened,” was her powerful take-home message for the participants.

Dr. Maria Catalina Ehsan, a Chilean national who has done her PhD in Environmental Sciences and is currently the principal of University College of Islamabad, shared her experiences as a cancer survivor. In spite of having the option of proceeding abroad, she preferred to get treatment at NORI, an institution which, she believes, gives paramount attention to patients; is quick to embrace new technologies and advancements in order to enhance patient care; and spends money on patient welfare. “Things improve here, day by day, month by month. Other government hospitals need to emulate the standards that NORI has established,” she remarked. Dr. Catalina is an inspiration for other patients, particularly those who find it difficult to make treatment-related decisions. She encourages patients to complete their treatment process in its entirety including the chemotherapy. Dr. Catalina was diagnosed with the help of screening when she was asymptomatic.

Dr Jamal Nasir, chairman of the Pakistan Green Task Force, advised the government to create breast cancer screening desks in public hospitals at the primary, secondary and tertiary levels. He termed rising political interference in the management of public hospitals as the core impediment in way of their efficient working.

Former parliamentarian and ex-managing director of Pakistan Bait-ul-Mal Zamurrad Khan expressed his intention to support NORI, both financially as well as morally. He exhorted the government to devise a strategy leading to the provision of affordable cancer treatment for poor patients. He urged the oncologists to rethink how the prices of cancer medicines can be brought within the reach of the common people.

Dr Amjad Mehmood, registrar of the Pakistan Medical and Dental Council (PMDC), hoped that NORI will now produce more oncologists so that there are adequate specialists in Pakistan to deal with the rising incidence of cancer.

Professor Khaleeq-uz-Zaman, head of the Department of Neurosurgery at PIMS, pointed out that until the disease shows a downward trend, cancer days should be ‘mourned’ and not ‘celebrated’. He termed leadership and team work as the main prerequisites for any institution to rise and shine.

The event was followed by exchange of mementos and a walk against breast cancer.